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National Immunization Strategy 2017-2022


Foreword
 
There have been many transformations to the NIP inthe recent years. New vaccines wereadded to the vaccination schedule, the cohorts served by the public sector kepton expandingsince the onset of the Syrian crisis, measures to consolidatethe vaccine purchasing arrangements were adopted,and there wasa leveraging up ofthe vaccinovigilanceand its effective management.In 2016, the Ministryof health in Lebanon decided that it was the time to take stock, constructon the current NIP strengthsand achievements andidentify areas for further improvement. A strategy for the NIP for 2016-2020 wasenvisagedin agreementwith the development partners. A detailed situation analysis assessment was initiatedin October 2015 in two stages: at the initial stage, the country and health system contexts were analyzed, and immunization system performance was measured. In the second stage, a framework was developed in consultations with key stakeholders to define gaps in the evidence. Immunization coverage evaluation survey was conducted in 2016 and fed into filling the lacunas in information.

The present document expresses the country vision, goals and priorities of the national immunization program. It relies on a careful examination of the situation analysis, an assessment of the enablers and challenges facing the immunization services and defines the national immunization strategies addressing these contests. The strategies were formulated as informed choices across more than one solution deemed most feasible and efficient considering the country context.

The document is structured in three sections:

Section 1“Situational analysis” presents briefly the organization and operation of the national immunization program as well as the recent achievements and remaining challenges,

Section 2 “Conceptual framework” describes the future vision of the country in regards to vaccine preventable diseases, the long term goals to be achieved and the more specific results –immunization system objectives and targets for 2020,

Section 3 defines the Strategies to address the bottlenecks and achieve immunization system objectives by 2020. Most of strategies (so called “immunization system specific” ones) are presented by relevant health system blocks.The focus of the NIP Strategy, is to assistthe MOPH to meet international goals set by the World Health Organization (WHO) under the Global Immunization Vision and Strategy (GIVS). The Strategy articulates action areas to conserve the successful achievements of the last years, built on the current favoring momentum and propose solutions for the drawbacks

The Strategy comprises nineStrategic Priority Areas to complement and strengthen the NIP.

The matrix (Figure 2) in Annexesshows expected results of the immunization system development strategies by health system building blocks and links them to the root causes (weaknesses and treats) identified during the system analysis...
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ATC Name B/G Ingredients Dosage Form Price
B05BA10 PERIOLIMEL N4E B Olive oil + Soja oil - 45.00g, Alanine - 5.50g, Arginine - 3.72g, Aspartic Acid - 1.10g, Glutamic Acid - 1.90g, Glycine - 2.63g, Histidine - 2.26g, Isoleucine - 1.90g, Leucine - 2.63g, Lysine - 2.99g, Methionine - 1.90g, Phenylalanine - 2.63g, Proline - 2.26g, Serine - 1.50g, Threonine - 1.90g, Tryptophan - 0.64g, Tyrosine - 0.10g, Valine - 2.43g, Sodium acetate, 3H2O - 1.73g, Sodium glycerophosphate, H2O - 2.87g, Potassium chloride - 1.79g, Magnesium chloride, 6H2O - 0.67g, Calcium chloride 2H2O - 0.44g, Glucose monohydrate - 123.75g Injectable emulsion 5,288,020 L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 500mg Injectable powder L.L
M01AB55 PANCLO B12 G Diclofenac sodium - 75mg, Betamethasone disodium phosphate - 2mg, Hydroxocobalamin sulphate - 10mg Injectable solution 1,158,392 L.L
N01BB54 PRILA G Prilocaine - 2.5% w/w, Lidocaine - 2.5% w/w Cream 1,057,604 L.L
A03AX12 PHLOROGLUCINOL/TRIMETHYLPHLOROGLUCINOL ARROW G Phloroglucinol - 40mg/4ml, Trimethylphloroglucinol - 0.04mg/4ml Injectable solution 940,690 L.L
J01EE01 PAEDIATRIC CO-TRIMOXAZOLE MIXTURE G Trimethoprim - 40mg/5ml, Sulfamethoxazole - 200mg/5ml Suspension 190,698 L.L
G03FB01 PROGYLUTON B Norgestrel - 0.5mg (tablet 2), Estradiol valerate - 2mg (tablet 1, tablet 2) Tablet 193,513 L.L
A03CA02 PRIMAX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet 222,694 L.L
G03GA30 PERGOVERIS BioHuman Follitropin alfa - 150IU, Lutropin Alfa - 75IU Injectable powder for solution+diluent 6,523,011 L.L
A03DB04 PANADOL WOMAN B Paracetamol - 500mg, Hyoscine butylbromide - 10mg Tablet, coated 436,749 L.L
N02AJ06 PARACO-DENK 1000/60 G Paracetamol - 1000mg, Codeine phosphate hemihydrate - 60mg Suppository 636,981 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 100mcg/dose Inhalation powder 1,593,797 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 500mcg/dose Inhalation powder 2,605,711 L.L
J07AL01 PNEUMOVAX 23 B Polysaccharides from each of 23 capsular types of Streptococcus pneumoniae - 25mcgx23serotypes/0.5ml Injectable solution 2,378,601 L.L
J07AL02 PREVENAR 13 B Polysaccharide for serotypes 1, 3, 4, 5 , 6A, 7F, 9V,14, 18C, 19A, 19F, 23F (2.2mcg)Polysaccharide for serotypes 6B (4.4mcg)Conjugated to CRM197 carrier protein and adsorbed on aluminium phosphate (0.125mg aluminium) - Injectable suspension 6,352,343 L.L
J07AL02 PNEUMOSIL (10-VALENT) G Pneumococcal polysaccharide conjugate vaccine (adsorbed) - Injectable suspension 3,386,483 L.L
M01AE51 PROFINAL XP G Ibuprofen - 400mg, Caffeine - 65mg Caplet, film coated 286,238 L.L
J07AL02 PREVENAR 20 B Pneumococcal polysaccharide for serotypes 1, 3, 4, 5 , 6A, 7F,8, 9V,10A, 11A, 12F, 14, 15B, 18C, 19A, 19F,22F, 23F, 33F (2.2mcg) Pneumococcal polysaccharide for serotypes 6B (4.4mcg)Conjugated to CRM197 carrier protein (approximately 51mcg) adsorbed on aluminium phosphate (0.125mg aluminium) - Injectable suspension 7,415,107 L.L
C09BA04 PRETERAX ARGININE B Perindopril arginine - 2.5mg, Indapamide - 0.625mg Tablet, film coated 452,875 L.L
C09BB04 PRESORYL PLUS G Perindopril arginine - 5mg, Amlodipine (besylate) - 5mg Tablet 557,695 L.L
J01CR05 PIPERACILINA/TAZOBACTAM SALA G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 913,813 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM SANDOZ G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 913,813 L.L
C09BB04 PRESORYL PLUS G Perindopril arginine - 10mg, Amlodipine (besylate) - 5mg Tablet 770,022 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM PANPHARMA G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 8,851,296 L.L
J01CR05 PRIZMA G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 913,813 L.L
C09BB04 PRESORYL PLUS G Perindopril arginine - 10mg, Amlodipine (besylate) - 10mg Tablet 770,022 L.L
D07CB01 PANDERM G Triamcinolone acetonide - 1mg/g, Gramicidin - 0.25mg/g, Neomycin (sulfate) - 2.5mg/g, Nystatin - 100.000IU/g Cream 180,075 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM STRAGEN G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 897,687 L.L
D07CB01 POSITON G Triamcinolone acetonide - 100mg, Neomycin (sulfate) - 250mg, Nystatin - Cream 1,064,323 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM STRAGEN G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 7,820,986 L.L
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